The profile of hypothyroidism in India has changed completely over few decades. Iodine deficiency goitre has almost disappeared in most areas, thanks to the iodine supplementation of salt. Ironically, the incidence of hypothyroidism has increased in the population. Most of the cases lack goitre and many of them are hashimotos thyroiditis. We did a study and found very high prevalence (70%) of Metabolic syndrome among newly diagnosed hypothyroid patients. Homa IR was also quite high in them. There are many unanswered questions regarding the current day hypothyroidism in India. First, why is the prevalence around 6-8% in the population despite iodine supplementation? Second, how is insulin resistance related to the hypothyroidism? Third, Is metabolic syndrome associated with hypothyroidism in western world also? Fourth, is it the high salt and high sugar diet that binds metabolic syndrome and hypothyroidism together? High salt leading to high iodine induced damage and high sugar leading to obesity and metabolic syndrome in the same patient.
Some studies show that there isn't a connection, but maybe looking for more factors that weren't considered could provide new insights. (Links are provided) Has the diet of the population in India changed? Inflammation through Western diet habits could induce a shift to a proinflammatory and possibly autoimmune phenotype.
https://www.ncbi.nlm.nih.gov/pubmed/25172520
https://www.ncbi.nlm.nih.gov/pubmed/26214105
DM and thyroid disorders have been shown to influence each other, and associations between both conditions have long been reported. It has been observed that there is an increased frequency of thyroid dysfunction with advancing age and a higher prevalence of thyroid disease in women compared to men and in diabetic subjects compared to nondiabetics. (Feely J, Isles TE. Screening for thyroid dysfunction in diabetics. Br Med J. 1979;1(6179):1678).
There is a significant positive correlation between both antithyroid antibodies and serum TSH in diabetic patients suggesting an autoimmune mediated pathogenetic mechanism. Besides, thyroid disorders are found to be more common in subjects with T1DM compared to those with T2DM, due to the associated autoimmunity.
Dear colleague, the elevated serum concentration of thyroid-stimulating hormone (TSH) while the levels of circulating thyroid hormone are within the normal range is called subclinical hypothyroidism (SH). The incidence of SH varies between 4% and 10% depending on sex and age. The frequency of this mild thyroid dysfunction increases with age and its frequency is significantly higher in women.
Results from the study of M.M. Pesic et al. 2015 in Biotechnology & Biotechnological Equipment, 2015 Vol. 29, No. 1, 157-163 contribute to the correlation between the two seemingly unrelated entities, diabetes and thyroid dysfunction, and the factors which associate them. This is a recent and interesting article.
Samira,
Thankyou for your answer.
What we found was 75% prevalence of autoimmunity among newly diagnosed frank hypothyroidism. This is a total reversal of the trend compared to what we had 20 years back. Our place was full of goitre and iodine deficiency disorders was launched as a national program by the government. But 20 years down the line we have a sudden surge of autoimmune hypothyroidism. I agree that autoimmune hypothyroidism has higher TSH compared to the TSH in patients who were TPO negative. TPO positive patients were also 7 years younger than TPO negative group.
The correlation of TPO with HOMA IR or metabolic syndrome was however not found by us.
better iodine supply correlates with less goiter patients but more cases of Hashimoto Thyeroiditis. this is also our Observation. In the first years of better iodine Supplementation cases of autonomous nodules with hyperthyreoidism will also rise.
first iodine supplementation increased antigenicity of thyroglobulin then enhance AITD
Second hypothyroidism means low metabolic rate mode of the body so logically the insulin decrease in sensitivity by cells
Third, yes
Fourth, yes of course